• The Journal of Pediatrics of Korean Medicine
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• v.13 no.2
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• pp.149-170
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• 1999

The author measured IL-2, IL-4, IL-6, TNF-${\alpha}$ and total protein(TP) level of middle ear effusion(MEE) of 24 ears - 13 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang - of pediatric recurrent otitis media with effusion(PROME) using ELISA assay, and compared the level of cytokines(pg/ml)/TP(mg/dl). And investigated the clinical finding in those children. The results were obtained as follows: 1. The level of IL-2／TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.05). 2. The level of IL-4/TP in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P〈0.0l). 3. The level of IL-6/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.05). 4. The level of TNF-${\alpha}$/TP in Kami-hyunggyeyungyotang group was significantly lower than that in antibiotics group(P〈0.01) 5. 79.1% of children with recurrent otitis media with effusion(ROME) were also complicated to chronic sinusitis. The children's t-test was used to make a statistical comparison between the groups. According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by control produce of cytokines which are connected with inflammatory reaction.

• Pediatric Infection and Vaccine
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• v.15 no.1
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• pp.45-51
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• 2008

Purpose : Better understanding of the epidemiology of Streptococcus pneumoniae affects preventive and therapeutic strategies for children with otitis media. This study was undertaken to examine the prevalence of pneumococcal serotypes causing otitis media in children. Methods : Pneumococcal isolates obtained from the ear discharge of children with otitis media between January 2001 and December 2006 were characterized by serotyping and antibiotic susceptibility testing. Results : There were 54 pneumococcal isolates from 54 children with otitis media. The median age of patients was 13 months, and the proportion of children <5 years old was 81%. The predominant serotypes, in order of decreasing frequency, were 19A (44%), 19F(28%), 6B (7%), 6A (4%), 9V (4%), and 1 (4%); 23 isolates (43%) belonged to types included in the heptavalent pneumococcal conjugate vaccine (PCV7). The proportion of serotype 19A and 19F accounted for 72% of overall pneumococcal isolates, which accounted for 84% of pneumococcal isolates from otorrhea of children <5 years old (vs 20% in children ${\geq}5$ years old, P<0.001). All serotypes isolated from 3 vaccinees of PCV7 were 19A. There was no significant diminution in otitis media caused by pneumococcal vaccine serotypes after the introduction of PCV7. The frequency of nonsusceptibility to penicillin, erythromycin, and trimethoprim-sulfamethoxazole was higher in serotype 19A than in other non-vaccine serotypes, respectively. The frequency of multiple drug resistance was 96% in serotype 19A, compared with 29% in other non-vaccine serotypes (P=0.001). Conclusion : 19A was the most common pneumococcal serotype causing otitis media and represented a large proportion of strains with multiple drug resistance in children younger than 5 years of age.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.235-241
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• 2006

Streptococus pneumoniae is an important cause of invasive infections as well as non-invasive infections such as acute otitis media and sinusitis both in children and adults. Resistance of S. pneumoniae to multiple antimicrobials is increasing and poses therapeutic challenges, and prevention became more important. 23-valent polysaccharide vaccine has been used for the last several decades, but is not effective in children <2 years of age, the highest risk group of invasive diseases. Recently, a 7-valent pneumococcal protein conjugate vaccine(PCV) which is effective in infants and young children has been developed. The efficacy of PCVs against invasive pneumococcal disease and pneumonia is well established and is documented in several well-conducted studies. However, the effect of PCVs on otitis media is less obvious and more complex. PCVs clearly reduce diseases caused by vaccine-type(VT) pneumococci, but replacement of VT serotypes by non-VT serotypes in nasopharyngeal carriage of S. pneumoniae is responsible for the increase in acute otitis media caused by non-VT serotypes. Three years after introduction of PCV in the US, some increase of invasive infections with serotype 19A possibly due to serotype switching within certain vaccine type strains has been noted. Since most antibiotic-resistance in S. pneumoniae is confined to VT serotypes, vaccine use also reduces antibiotic resistance. With development of PCV, there was a great advance in the prevention of pneumococcal diseases, but replacement with potential virulent organisms and development of antibiotic resistance in non-VT pneumococci is a possibility that needs careful monitoring.

• Pediatric Infection and Vaccine
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• v.3 no.1
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• pp.94-100
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• 1996

Streptococcal pneumoniae is the second most coomon cause of meningitis in infancy and a major respiratory pathogen. It is the one of the most common cause of acquired pneumonia and otitis media in childhood. Intracranial extesion of acute otitis media occur somewhat more often from poorly pneumatized than from well-pneumatized temporal bones and in ears with a history of previous attacks of otitis media. We experienced a case of pneumococcal meningitis with 3 time recurrences in a 6 year-old male patient who had hospitalized with high fever, headache, vomiting and stupor mental state. He was diagnosed as CSF study and brain CT. Brain CT showed poorly pneumatized right mastoid region of temporal bone at that time. We report a case of pneumococcal meningitis with 3 time recurrences due to poorly pnematized mastoid region of temporal bone. A review of literatures was also presented briefly.

• The Journal of Pediatrics of Korean Medicine
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• v.15 no.1
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• pp.131-153
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• 2001

The author measured IgG1, IgG2, IgG3 and IgG4 levels of 22 ears-11 ears of them had treated by antibiotics, 11 of them by Kami-hyunggyeyungyotang-of pediatric recurrent otitis media with effusion using ELISA assay, and compared them. The results were obtained as follows. 1. The level of IgG1 in Kami-hyunggyeyungyotang group was significantly higher than that in antibiotics group(P=0.002). 2. The level of IgG2 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.178). 3. The level of IgG3 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.215). 4. The level of IgG4 in Kami-hyunggyeyungyotang group was higher than that in antibiotics group(P=0.198). According to above results, Kami-hyunggyeyungyotang is considered to be used for treatment 'recurrent otitis media with effusion' by controlling the production of immunoglobulins.

• Pediatric Infection and Vaccine
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• v.16 no.1
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• pp.13-23
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• 2009

Acute otitis media (AOM) and pneumonia are among the most common infectious diseases of children. Both are mucosal infections and share many common features such as etiological agents, pathogenesis and immunity. Influenza plays an important role in the pathogenesis of AOM and pneumonia. A vaccine against influenza may have substantial impact on these diseases during the influenza season. In clinical trials, influenza vaccine has reduced the incidence of AOM and pneumonia complicating influenza in children. However, the efficacy of vaccines has been controversial in children less than 2 years of age. Similarly, vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib), both common causes of AOM and pneumonia, have the potential to reduce the impact of disease. Clinical trials showed that the currently licensed 7-valent pneumococcal conjugate vaccine (PCV), administered during infancy, had an efficacy of 6-7% for the prevention of AOM, however, visits to the clinic for AOM were reduced by up to 20-30% after routine use in the U.S. Both Hib and PCVs have a proven effectiveness of >20% for prevention of radiologically confirmed pneumonia in children. The recently introduced pnuemococcal vaccine conjugated with protein D is expected to reduce AOM and pneumonia caused by non-typable H. influenzae, in addition to its effects on pneumococcal diseases. Considering their high incidence in children, recent achievements in the prevention of AOM and pneumonia with vaccines may have a significant economic and social impact.

• Journal of Veterinary Clinics
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• v.20 no.3
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• pp.308-311
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• 2003

Clinical outcomes of dogs treated for end-stage otitis extema with total ear canal ablation (TECA) combining lateral bullar osteotomy (LBO) at Veterinary medical teaching hospital of Seoul National University from 2001 to 2003 were evaluated. In 14 dogs, 23 ears, the operation was successful in alleviating all clinical signs of otitis externa and media. The main complication after TECA combining LBO were facial nerve paralysis and the others were recurrent infection and the formation of fistula and cyst. Two cases were tumors. One was ceruminous gland adenoma and the other was squamous cell carcinoma. The operation successfully resolved the original problems in 100% (23 of 23) of the surgically treated ears of these dogs.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.3.2-3
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• 1979

Bone conduction loss is one of the most common complication in chronic otitis media, and is mostly high frequency loss. Of 233 tympanomastoidectomy ears, 187 ears were considered eligible for this study. A histopathological change was examined in the natural otitis media of guinea pigs. It is our intention to analyze the pattern of bone conduction loss in chronic otitis media, and to correlate this findings with clinical and pathological changes in human and animal otitis media. l) In unilateral cases, a significant difference in bone conduction threshold was observed between normal and diseased ears, and between each frequency with significant interaction between 2KHz and 4KHz (p 0.01). 2) Using one way analysis of variance, mean bone conduction was compared with the duration of disease. We observed a significant difference (p 0.05) between each group of duration, except between 11-15 and 15-20 years group. 3) A comparison of bone conduction between stapes loss group and intact stapes group revealed significant t ratio (p 0.01) at each frequency. The effect of stapes loss on each frequency was evaluated, using one way analysis of variance. there were significant difference(p 0.05) between 250Hz and 500Hz. and between 2KHz and 4KHz. 4) A comparison of bone conduction between round window obliteration and nonobliteration group revealed significant t ratio (p 0.01) at each frequency. Using one way analysis of variance. the effect of round window obliteration was evaluated in each frequency. We observed significant difference (p 0.05) between 250Hz and 500Hz. and between 2KHz and 4KHz. 5) A comparison of bone conduction between cholesteatoma and non -cholesteatoma group revealed significant t ratio (p 0.01) only in 2KHz and 4KHz. No significant differency was observed in mean bone conduction. 6) In a histopathological study of natural otitis media in guinea pig, we observed inflammatory infiltration of the round window membrane, serofibrinous precipitate in the scala tympani, and degeneration of the organ of Corti most significant near the basal turn. These changes would explain high tone bone conduction loss in the process of chronic otitis media.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.192-194
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• 2008

A 15-month-old, intact male, domestic short hair cat was presented with ataxia, protrusion of the right third eyelid, and anorexia. Clinical signs were firstly noted after ear cleaning at home. Symptoms of the Homer's syndrome were evident. However, postural and proprioceptive reaction deficits were not detected on neurologic examination. Otoscopic examination revealed foreign body in right ear canal. A diagnosis of peripheral vestibular syndrome was made based on results of physical examination including neurologic and otic examination, blood work, and magnetic resonance imaging (MRI). Based on these examinations, the present patient was definitely diagnosed as otitis medial interna induced by foreign body. The vestibular signs were resolved 10 days after removal of cotton tips in right ear canal. This case report indicates that home-care cotton swab can iatrogenically induce otitis media/interna in cats.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.5 no.1
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• pp.133-142
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• 1992

We analyzed clinical study in 47 patients, who had visited to the Dept. of Otolaryngology, Hospital of Oriental Medicine, Kyung Hee University to treat Otitis media with effesion from March, 1991 to February, 1992. The clinical etiology of O.M.E. was tubal occlusion, acute otitis, and allergy. The clinical symptoms were hearing loss, tinnitus, sneezing, coughing, Chun-I(纏耳), and BEE-Yeon(鼻淵) in the Oriental Medicine. The results were as follows. 1. There were 26 males ($55\%$) and 21 females ($45\%$) in sex. 2. The peak age at onset was 1-4 years old (11Cases). 3. Bilateral effusion was in $62\%$, and unilateral in $38\%$. 4. The etioloigic factors were upper respiratory infection 16 cases, Allergic rhinitis 13 cases, Sinusitis 8 cases, etc. 5. The most common chief complaint was hearing loss ($30\%$). 6. There was no significant difference between blood types in O.M.E., ( A type $30\%,\;B\;type\;25\%,\;AB\;type\;13\%,\;0\;type\;13\%$, Unknown recorded $9\%$ ). 7. $21\%$ patients prefered warm and the others cold 8. As for digestion, good was in 31 cases ($81\%$), and poor 9 cases ($19\%$). 9. Man-Hyung-Ja-San Extract was most used in treatments as $38\%$, O-Ryung-San $35\%$ in descending order. 10. As for treatment period, 14 cases were treated over 12 weeks, 9 cases below 1 week